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Block feeding not reducing supply?! and pain question

Hi ladies. I'm a first time mommy with OS and OALD.

I have been block feeding (2-3 feedings per side, 2-4 hours from start of one feeding to start of the next) my six week old son for over a week.

However, my supply does not seem to be going down. On the contrary, I have been dealing with engorgement for 4-5 days now. This is longer than the engorgement I had when my milk first came in (only about 2 days then). I have been quite consistent about doing multiple feedings per side in a row, although not consistent about how many, exactly; basically I stay on one side for 6-8 hours unless the other side becomes engorged enough to hurt without being touched. Sometimes I have gone and stood over the sink (with my torso horizontal) and simply allowed the pressure of the weight of my breast to cause a letdown, until it stops spraying and just drips.

About 2 weeks ago I was afraid we could have thrush because I was having stabbing pains that seemed like needles were traveling from my nipple up the duct paths all the way to my chest. It stopped/got better (which I understand thrush does not do), and looking back I wonder if some of it was the LO clamping and pulling while sucking that caused some of that pain. But, now I seem to get prickly pain in the middle/core of my breast and from the middle of each breast to my chest on the outside/skin side - i always have to check and see if LO's fingernails poked/scratched me or if it is just a pain inside my own body (usually just my own body, but that tells you what it feels like). These are more likely to happen when I am fully engorged.

The baby does eat enough to soften me up in one feeding, and by the end of the first feeding, if it's long, or by the second feeding at least, I am seeing the opaque white hindmilk, and my breast is niiice and mushy, so that's good.

The past two days he's been eating closer to every 4 hours instead of every 3-4 hours. Sometimes at night he'll make it 5-6 hours, sometimes only 4. He is gaining weight fine (I wonder if it's too much too fast, he's almost 11 lbs at 6.5 weeks but was 6 lbs when we brought him home from the hospital!) But, aside from gassiness that just won't go away (not shockingly), he is actually a very good, happy baby.

Re: Block feeding not reducing supply?! and pain question

Hello and ,

It sounds like you're doing all the right things. Block feeding can take a few weeks to take effect, so try to be patient with yourself. It does get better!

I have been quite consistent about doing multiple feedings per side in a row, although not consistent about how many, exactly; basically I stay on one side for 6-8 hours unless the other side becomes engorged enough to hurt without being touched. Sometimes I have gone and stood over the sink (with my torso horizontal) and simply allowed the pressure of the weight of my breast to cause a letdown, until it stops spraying and just drips.

This sounds like a very good strategy. I don't think you need to change a thing at this point.

How often every 24 hours would you say baby is feeding? Sometimes, shorter more frequent feedings are best for getting more hindmilk to the baby, and reducing gassiness. As long as you stick to those 6-8 hour blocks, it doesn't really matter how often baby nurses on each side. It is clear from your post that baby is gaining well.

If, after another week or so, you still don't feel like the block feeding is working, you could increase the length of the blocks. You can go up to 12 hours per side for a severe case of oversupply.

Re: Block feeding not reducing supply?! and pain question

At night, he can go 4-5.5 hours. During the day, depending on how sleepy he is, he may go 3-4 hours. In the late evening/before bed, he typically asks for it about every 2 hours, and might eat more often than that if I offered it.
He usually eats for real (ie sucking and swallowing consistently) for 5-10 minutes, then if he continues it's very slow, "suck suck wait for 15-20 seconds suck swallow".

Some further questions:

Do you think he is gaining too much weight, too fast? He has also gained in length, so I haven't been concerned enough to ask the doctor (i'll ask at my 2month appt), but... I'll ask you! Starting at 6 lb 5 oz and 18.5 inches at birth (6 lbs when we went home), at almost the 7 week birthday he is nearly 11 lbs and roughly 22 inches long.

As far as the pains I described, do those seem like a cause of concern to you? I don't have any red lumpy areas, which seems to be the only description I can find of plugged ducts...

I'm trying to decrease my supply, but I have a need to pump so that I have a supply of expressed milk both for emergencies and because soon, I am supposed to be returning to work (kinda- I'm supposed to go in to work a couple evenings a week; I was going to leave my son with my husband during that time and they'll need some milk available.) What do you suggest? When should I pump? I considered pumping for a short time, 60 seconds? per feeding after baby is done (to "fool" the breast) and combining all the pumps for the day into one storage bag. Is this safe (combining milk from multiple pump sessions, by adding new warm milk to a bag of milk that has already cooled in the fridge for a couple hours)? Do you think that would be effective at not confusing my breasts?

Re: Block feeding not reducing supply?! and pain question

Originally Posted by Adelas

Some further questions:

Do you think he is gaining too much weight, too fast? He has also gained in length, so I haven't been concerned enough to ask the doctor (i'll ask at my 2month appt), but... I'll ask you! Starting at 6 lb 5 oz and 18.5 inches at birth (6 lbs when we went home), at almost the 7 week birthday he is nearly 11 lbs and roughly 22 inches long.

Babies gain weight at different rates, and there is a wide range of what is considered "normal". Remember that babies in the 99th percentile--as well as babies in the 2nd percentile--are still in the range of "normal". A fast gaining baby is typical when mom has oversupply. It's usually nothing to worry about, and most of these babies "thin out" as they get to be 6 months or so and become mobile.(So, your 99th percentile baby may suddenly be down in the 70th or the 50th, and that's okay, too). It is nearly impossible to overfed a breastfed baby, as long as he is only feeding at the breast (no bottles, cups, solids, etc.). If you have concerns about your baby's weight gain, talk to your health care provider.

As far as the pains I described, do those seem like a cause of concern to you? I don't have any red lumpy areas, which seems to be the only description I can find of plugged ducts...

Some women have a "pins and needles" sensation when their milk lets down. This kind of pain is usually not a problem, and normally goes away on its own over time, as your post partem hormones even out. That could be what you are experiencing. Here's some more information: http://www.llli.org/FAQ/pain.html

You are correct in saying that thrush does not go away on its own. On the contrary, it can be fairly difficult to treat. If you suspect you have thrush, you and your baby should be examined by a breastfeeding-knowledgable health care provider. A local IBCLC may also be able to give you a good idea of whether or not what you are experiencing is due to thrush, and refer you to a supportive health care provider for treatment.

Here's some more information on plugged ducts and mastitis that might help:

I'm trying to decrease my supply, but I have a need to pump so that I have a supply of expressed milk both for emergencies and because soon, I am supposed to be returning to work (kinda- I'm supposed to go in to work a couple evenings a week; I was going to leave my son with my husband during that time and they'll need some milk available.) What do you suggest? When should I pump? I considered pumping for a short time, 60 seconds? per feeding after baby is done (to "fool" the breast) and combining all the pumps for the day into one storage bag. Is this safe (combining milk from multiple pump sessions, by adding new warm milk to a bag of milk that has already cooled in the fridge for a couple hours)? Do you think that would be effective at not confusing my breasts?

When will you be returning to work? Many mothers with oversupply do not need to "save up" milk for when they return to work. They simply pump enough while they are at work to feed baby the next day. If you want a little bit of an emergency stash, you might consider holding a bottle under your other nipple while baby is nursing, and allowing your milk to drip into it. Most moms with OALD find that they leak quite a bit--or even have a full letdown--on the other side while they are nursing. By collecting your milk in this way, you won't need to do any additional breast stimulation.

You should cool your milk in the refridgerator before adding it to other refridgerated or frozen milk. Human milk may be stored at room temperature for up to 10 hours. Here is a link to more information: http://www.llli.org/FAQ/milkstorage.html

Re: Block feeding not reducing supply?! and pain question

I would not suggest pumping after nursing because that can tell your body to make more milk. The idea of block feeding is to tell your body to make only the milk it needs for your baby. If you pump a few oz. after a nursing session, you are essentially telling your body that baby needs more milk than they are actually drinking. It might not be that bad if you are only doing this say, once a day, but I would hold off on it till after your milk supply is better balanced if you can. maybe you can collect during an unwanted letdown? I didn't start storing milk really untill about a week before I went back to work, but I did only go back part time for only about a month, so I might not be the best one to ask.
You might try offering the breast every hour or 2 for a little while, keeping to your block time schedule still. My son nursed fairly often, and I found that I had less engorgement nursing him hourly for 2-3 times on each side thand then switching. Of course we slowly stretched out after that.
Also he is 15 mo. and we still only nurse on one side at a time, even though he is able to switch sides every time.
Hang in there, it does get better!

Re: Block feeding not reducing supply?! and pain question

Thanks girls for the encouragement. I'm still being a but the painful hard engorgement settled in the past few days.

My concern about collecting letdown milk to save is that it is all foremilk. You can tell by watching it come out; it is nearly clear. Wouldn't that be a problem? (Although I bet I letdown an ounce at a time once it's "mad" enough to leak/spray)

Also I am sure the pain is not letdown; I am familiar with that sensation from the "uh oh" factor - uh oh, I'd better get a towel before I soak his pants while feeding at the other breast; uh oh, I didn't put in a breast pad, that kind of thing For me it's a pinching sensation as my nipples get hard and stand out.

The pain I am asking about is generally farther back/deeper than my areolas, or out farther on the side. There are two aspects of the pain that occur together or at different times. When it is a shooting pain it may begin in the nipple; when it's a stinging itch it seems to be near or in the skin. If you have ever had heat rash or touched a nettle and got a thread-thorn from it in your finger, the itchy pain is like that.

Re: Block feeding not reducing supply?! and pain question

Originally Posted by Adelas

Thanks girls for the encouragement. I'm still being a but the painful hard engorgement settled in the past few days.

My concern about collecting letdown milk to save is that it is all foremilk. You can tell by watching it come out; it is nearly clear. Wouldn't that be a problem? (Although I bet I letdown an ounce at a time once it's "mad" enough to leak/spray)

Do you have a second letdown midway through the feeding? Even if it is not as strong, a second letdown would likely be hindmilk. If not, when you sense that baby is drinking hindmilk (deeper, slower swallows...often when baby starts to get sleepy), you could hand express or pump a little on the opposite side, just until you letdown.

Also I am sure the pain is not letdown; I am familiar with that sensation from the "uh oh" factor - uh oh, I'd better get a towel before I soak his pants while feeding at the other breast; uh oh, I didn't put in a breast pad, that kind of thing For me it's a pinching sensation as my nipples get hard and stand out.

The pain I am asking about is generally farther back/deeper than my areolas, or out farther on the side. There are two aspects of the pain that occur together or at different times. When it is a shooting pain it may begin in the nipple; when it's a stinging itch it seems to be near or in the skin. If you have ever had heat rash or touched a nettle and got a thread-thorn from it in your finger, the itchy pain is like that.

This kind of pain sounds like thrush to me. Have you and your baby been checked for thrush by a health care provider? A local IBCLC might be a good resource for thrush treatment information, as well as referal to a supportive health care provider.

Re: Block feeding not reducing supply?! and pain question

FWIW, I have read that OS & OALD are symptoms of gut problems. That paired with the feeling you might have thrush leads me to believe your diet and gut health could be partially to blame. You might want to try cutting back on sugar and grain products (all refined/processed foods ideally) for a little while and see if that helps. You could also introduce yogurt and probiotics into your diet for a boost to your good gut flora. Just some ideas and my two cents.